Can codeine cause heart problems?

[PieceByPiece]

Can codeine cause heart problems? If so, what kind?

 

[szuko000]

I can not think of any heart issues that can arise from codeine alone. Generally speaking opiates are not cardiotoxic and are metabolized without any harmful byproducts being created. Codeine is structurally similar to morphine and even has morphine as a metabolite so I would be surprised if it was cardiotoxic. I could see it putting strain on the liver just because it is a "toxin" (according to the body not me) so it needs to be metabolized but beyond that, nothing comes to mind.

Is there any specific reason as to why you are asking aside from a general curiosity?

 

[Rachella666]

No. If that was the case then id be having a coronery as we speak! Its the liver andnkidneys it affects xxxRachelxxx

 

[《Plasticity》]

To be fair, recent studies show that opioid users were at a higher risk of cardiovascular events than users of other methods of pain relief so while codeine may not cause direct damage to the heart a la 5-ht2b induced valvulopathy, chronic use does increase the risk of heart attack and stroke. What's even more surprising is that although codeine is considered the weaker, safer opioid it was actually deemed riskier than all other opioid it was tested with (hydrocodone, oxycodone, tramadol, and even propoxyphene... a drug taken off the market due to fatal arrhythmias).

Here's an overview of the two studies from harvard, I'll include the part that specifically talks about codeine. I would dig deeper into how these two studies came to this conclusion, I'll admit that I haven't looked into it much. If your at high risk of having a heart attack or stroke and/or have heart disease regular use of codeine may not be a good idea, especially if your dealing with coronary issues.

Codeine not-so safe

As for the second study comparing the five opioid drugs, the biggest surprise there was that codeine emerged looking much riskier than the other four drugs with respect to cardiovascular events and all-cause mortality.

That’s unexpected because doctors tend to view codeine as a milder, safer opioid. An editorial in the Archives about the study talks about codeine being a “middle-ground treatment” between all the various non-opioid painkillers and the more powerful opioids.It continues:

The untested but widespread assumption that codeine is safer from an addiction standpoint because of its lower potency may need to give way to these data demonstrating increased risk of cardiovascular events and all-cause mortality. If codeine is of middling efficacy for pain and is more risky than other opioids, there would be little reason to use it.

Of course, as the editorial points out, it will take more research to figure out whether that is really the case.

http://www.health.harvard.edu/blog/the-safety-of-painkillers-20101220915

 

[ThePharmacist4925]

I know an older guy who had a heart attack when he was going through oxycodone withdrawals. I don't know if there was a correlation or not, but that's a true story. I would be inclined to believe that opiates could affect cardiovascular health, however I don't know how common that would be or in what way the opiates would affect cardiovascular health. Just some thoughts, take with a grain of salt